Vivian Ann Jackson, LMHC in Starke, FL - Medicare Counselor Provider

Vivian Ann Jackson, LMHC is a medicare enrolled "Counselor - Mental Health" provider in Starke, Florida. Her current practice location is 945 Grand St, Starke, Florida. You can reach out to her office (for appointments etc.) via phone at (352) 374-5600.

Vivian Ann Jackson is licensed to practice in Florida (license number MH17142) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1922210210.

Contact Information

	Vivian Ann Jackson, LMHC
	945 Grand St, Starke, FL 32091-1821
	(352) 374-5600
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Vivian Ann Jackson
Gender	Female
Speciality	Counselor - Mental Health
Location	945 Grand St, Starke, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1922210210
Provider Enumeration Date: 05/07/2007
Last Update Date: 03/23/2022

Medicare PECOS Information:

PECOS PAC ID: 8628411378
Enrollment ID: I20240209000041

Medical Identifiers

Medical identifiers for Vivian Ann Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1922210210	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	MH17142 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Vivian Ann Jackson allows following entities to bill medicare on her behalf.

Entity Name	Quality Bhs Florida Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689297541 PECOS PAC ID: 4082030721 Enrollment ID: O20200812002561

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Vivian Ann Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Vivian Ann Jackson, LMHC 4300 Sw 13th St, Gainesville, FL 32608-4006 Ph: (352) 374-5600	Vivian Ann Jackson, LMHC 945 Grand St, Starke, FL 32091-1821 Ph: (352) 374-5600

Reviews and Comments

Counselor in Starke, FL

Terria Latrice Bowser, Counselor Medicare: Not Enrolled in Medicare Practice Location: 945 Grand St, Starke, FL 32091 Phone: 352-374-5600
Shira Callahan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 945 Grand St, Starke, FL 32091 Phone: 352-374-5600
Judith Ann Razzano, Counselor Medicare: Not Enrolled in Medicare Practice Location: 17356 Us Highway 301 N, Starke, FL 32091 Phone: 440-541-4043
Christopher Walker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 945 Grand St, Starke, FL 32091 Phone: 352-374-5600
Chareisha Jonas, Counselor Medicare: Not Enrolled in Medicare Practice Location: 945 Grand St, Starke, FL 32091 Phone: 352-374-5600
Ms. Linda A. Vanwulfen, MA, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1250 Andrews Cir, Starke, FL 32091 Phone: 904-964-1540
Tenika Gray, Counselor Medicare: Not Enrolled in Medicare Practice Location: 945 Grand St, Starke, FL 32091 Phone: 352-374-5600

Vivian Ann Jackson, LMHC - Medicare Counselor in Starke, FL